[Therapy of amyloid nephrosis in Crohn disease: plasmapheresis plus azathioprine?]

A 38-year old woman with serious nephrotic syndrome due to kidney amyloidosis in consequence of Crohn's disease was observed. The long-term prognosis of this illness is serious, but since in the literature several good results have been mentioned under treatment with immunosuppressives, in the present case an aggressive immunosuppression was carried out, which was started under the conception that, in consequence of elimination of preamyloid substances from the serum by plasmapheresis in combination with an additional inhibition of the reproduction of these substances by azathioprine, the clinical picture could be favourably influenced. During therapy with long-term intermittent plasmapheresis in combination with azathioprine a complete remission of the nephrotic syndrome was achieved.